CITY OF RIVERTON (307) 856-9129
816 NORTH FEDERAL BLVD., RIVERTON, WY 82501
HOME OCCUPATION PERMIT APPLICATION
Page 1 of 3
TO: Board of Adjustment
Pursuant to Riverton Municipal Code Chapter 17.20.040, I request approval and issuance of a Home Occupation Permit for the current year: April 1, 20 through March 31, 20 .
Fill out completely:
1. PERSONAL NAME:______
BUSINESS NAME: ______
PHYSICAL ADDRESS: ______
MAILING ADDRESS: ______RIVERTON, WY 82501
HOME PHONE: ______BUSINESS PHONE: ______
EMAIL ADDRESS:
2. WYOMING STATE SALES TAX LICENSE NO.______
(If exempt, attach copy of tax exemption)
3. GENERAL DESCRIPTION OF BUSINESS OR OCCUPATION: ______
______
4. PLEASE DESCRIBE IN DETAIL:
a. Equipment and machines utilized: ______
______
______
______
b. Raw materials utilized, quantity on hand, and storage location: ______
______
______
______
c. Other supplies utilized, quantity on hand, and storage location: ______
______
______
______
HOME OCCUPATION PERMIT APPLICATION
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d. Waste or by-products, quantity, storage location, and method of disposal:
______
______
e. Describe all possible noise levels, vibrations, smoke, dust, odors, heat, glare, emissions, etc., of business: ______
______
f. Describe any storage or use of toxic, explosive, or other dangerous materials upon the premises: ______
______
5. ZONING: ______
6. MODIFICATIONS REQUIRED: ______
______
Attach approved Building Permit (if applicable)
7. LOCATION OF BUSINESS OR OCCUPATION ON PREMISES:
_____ Home _____Garage _____Basement _____ Accessory Building
a. Attach a sketch of area occupied by business or occupation within the selected location on the premises and indicate square footage of area.
b. What is the square footage of the living area of the premises? ______
8. PARKING REQUIREMENTS:
a. Maximum number of vehicles at one time: ______
b. Location of parking: ______
Please attach a sketch of premises to indicate parking. See RMC 17.20.040(8)
9. A sign may be attached to the building in which the home occupation is practiced. This sign shall not exceed two square feet. See RMC 17.20.040(4).
Will you have a sign? ______If so does your sign comply? ___ Yes ___ No
10. HOURS OF OPERATION:
a. Months: ______c. Days of Week:______
b. Weeks: ______d. Hours of Day: ______
HOME OCCUPATION PERMIT APPLICATION
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11. Will the proposed home occupation be conducted entirely within the dwelling or an accessory building as per RMC 17.20.040A.1.? ______
12. Will the proposed home occupation be conducted by the inhabitants living there and no others as per RMC 17.20.040A.1.?______
13. Is the proposed home occupation in conformance with all covenants and agreements recorded with the registrar of deeds for the county, covering the land underlying the dwelling?______
14. I have provided notice to all owners and renters within 140 feet of this property pursuant to Riverton Municipal Code Section 17.20.040(B)(1). _____Yes _____ No
15. Do you own this residence? ____Yes Or do you rent this residence? _____Yes
______
(Signature) (Date)
FOR OFFICE USE ONLY:
DATE APPLICATION FILED: ______
DATE PUBLISHED: ______
DATE OF HEARING: ______
APPROVED: ______DENIED: ______
______
Chairman, Board of Adjustment
New Application Fee $110.00
Paid: ______Check #______
Revised 1/20/14